> Health: Good news with lots of buts… – Jaime Galvez Tan
|Health: Good news with lots of buts…
By Jaime Galvez Tan
Philippine Daily Inquirer
First Posted 02:08:00 07/26/2009
MANILA, Philippines—July 2009 is the start of the last year of President Gloria Macapagal-Arroyo’s term. How has the state of the nation’s health fared during the past eight years of her leadership? There is good news—with a lot of “buts”—and bad news.
The good news but…
Population. The population growth rate went down from 2.34 percent (1990-2000) to 2.04 percent (2000-2007) based on the National Census of 2007. However, the target growth rate by the end of 2010 is 1.95 percent.
Despite this decrease in the population growth rate by 0.30 percent, the number of Filipinos goes up by 1.5 million each year, or an increase of 4,109 per day, 170 babies per hour, or three births per minute.
As of July 2009, the population count is estimated to be 91.5 million. The population in 2007 stood at 88.57 million.
And the bad news
Contraceptive prevalence rate (CPR): The CPR is the level of contraceptive use of married women aged 15 to 49 years. It is the best measure of the effectiveness of family planning services in the country.
According to the National Health and Demographic Survey (NHDS) of 2003 and 2008, the CPR remained static between 2003 at 49 percent and 2008 at only 51 percent. The rate of modern contraceptive use, however, showed no improvement at all, from 33 percent in 2003 to 34 percent in 2008.
The most commonly used modern method is the pill (16 percent), followed by sterilization (9 percent). The modern natural family planning method which is the only method the Arroyo administration advocates had a measly 0.5 percent use in 2008. Modern natural family planning methods include the mucous/billings/ovulation method, standard days and lactational amenorrhea method.
Clearly, despite radio and television advertisements on the natural family planning method, the number of users is almost nil.
Child health: The good news but…
Infant mortality rate (IMR). The infant mortality rate is measured by the number of deaths of infants 1 year of age or younger per 1,000 live births.
The country’s IMR in the 2003-2007 period was 25, a 14-percent improvement from the IMR of 29 in 1998-2002.
However, the National Statistics Office says the decline in the IMR is statistically insignificant. This means there has been no substantial change in the quality of life of Filipino infants during the last eight years.
Under-five mortality rate. This refers to the number of children who die by the age of five per 1,000 live births. During the years 2003-2007, the recorded under-five mortality was 34, a 15-percent improvement from 40 in 1998-2002.
Millennium Dev’t Goals
Reducing by two-thirds, or 67 percent, the mortality rate among children under five is the fourth of the Millennium Development Goals, the United Nations’ eight-point anti-poverty framework for conquering global poverty by 2015.
In September 2000, 192 UN member states and 23 international organizations signed the UN Millennium Declaration committing themselves to a global partnership to achieve the eight international development goals by 2015.
Using the under-five mortality rate value of 54 in 1993, 48 in 1998, 40 in 2003, and 34 in 2008, it can be said that the average improvement rate per five-year interval is at 14.33 percent. If plotted on a graph, the projected value by the year 2013 would be 29, and roughly 27 by 2015. The MDG was formulated in 2000, and therefore using the value of 48 in 1998 as a point of reference, the Philippines’ target rate by 2015 is a value of 16.
With this data, we can conclude that although the under-five mortality rate is improving, progress has been slow. If we continue with our current rate, we would fail to achieve the fourth MDG.
Percentage of fully vaccinated children. In accordance with World Health Organization guidelines that children be fully vaccinated during the first year of life, 70 percent of Filipino children were fully vaccinated, as reflected in the 2008 NHDS.
This represented a 17-percent improvement from the 60 percent recorded in the 2003 NHDS.
This is the only bright and shining achievement in child health by the Arroyo administration since previous percentages of fully vaccinated children have been below 60 percent.
Child health: the bad news
In terms of childhood diseases like short rapid breathing (the major symptom of acute respiratory infections), fever (a symptom of malaria) and diarrhea, only half of the total number of children who contracted these diseases sought treatment from a health facility or provider as reflected in the 2008 NHDS.
Keep in mind that these diseases are considered major causes of child mortality in developing countries like ours. In addition, only 34 percent of infants under six months of age are exclusively breastfed, the lowest ever in 25 years.
No good news in maternal health
Maternal mortality ratio (MMR). This refers to the number of maternal deaths per 100,000 live births. MMR in 2006 was 162, a 6-percent improvement from an MMR of 172 in 1998.
Using the MMR values of 200 in 1990, 172 in 1998, and 162 in 2006, it is worthwhile to note that between 1990 and 1998, the improvement rate was 14 percent while that between 1998 and 2006 was only 6 percent, an almost 50-percent drop in improvement rate.
A reduction of MMR by three-quarters by 2015 is the fifth Millennium Development Goal.
The six other MDGs are: eradicate extreme poverty and hunger, provide universary primary education, promote gender equality and empower women, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability and develop a global partnership for development. With Dr. Allison E. Gocotano
(Jaime Galvez Tan was health secretary during the Ramos administration. He also served as Vice Chancellor for Research of the University of the Philippines-Manila and executive director of the National Institutes of Health.)